PID2: IMPACT OF CYTOMEGALOVIRUS (CMV)-RELATED READMISSION ON POST HEART TRANSPLANT RESOURCE USE

Abstract

OBJECTIVES: The incidence and costs associated with the rehospitalization of heart transplant patients for the treatment of CMV infection have not been well documented. Two adult heart transplant centers participated in a Transplant Infection Cost Analysis program that was implemented in several centers covering different solid organ programs. METHODS: A retrospective chart review of all patients rehospitalized within two years post-transplant identified the number of such readmissions, hospital costs and charges for the CMV associated readmission, and the length of stay. Data were pooled for analysis. All dollar amounts were standardized to 1997 dollars using the Medical Care component of the Consumer Price Index. RESULTS: Between 1994 and 1996, the two hospitals performed a total of 163 heart transplants. There were a total of 34 readmissions (21%) to these hospitals associated with a CMV infection. Total direct hospital costs were $740,220 (average $21,771 and range $1,324–$349,224). Total related charges were $1,431,793 (average $42,111 and range $2,323–$698,447). Total days of inpatient care for CMV infection were 371 days (average 10.9 and range 2–95) at an average cost per day of $1,997. CONCLUSIONS: Data from two heart transplant centers demonstrate that CMV infection caused significant readmissions. Use of hospital resources to treat CMV infection one to two years post-transplant was substantial. Total cost of CMV was not captured: readmission to other hospitals, outpatient costs, physician costs, mortality and lost productivity should be included for a complete assessment of the economic burden of CMV infection.